The specific aim of this competitive renewal of our training program in Trauma, Sepsis, Inflammation, and Critical Care is to develop physician/scientists who are well grounded in physiology, molecular biology, and molecular genetics. This program is designed to teach interested individuals to develop hypothesis-based research plans, enabling the trainees to transfer developments and new information from bench to bedside, leading to the development of novel and innovative therapeutic strategies in trauma and critical care. This training program is devoted to two years research training, and candidates for the training program must have an MD or PhD degree from an accredited medical or graduate school;only United States citizens or permanent residents are eligible. A two-year research commitment is required, and MD trainees are expected to have completed at least three years of postdoctoral training prior to beginning the fellowship. To achieve an understanding of the cellular and molecular mechanisms underlying organ failure in trauma and sepsis, trainees are placed in laboratories under the direction of scientific preceptors where state-of-the-art scientific methods are available and preceptors are committed to the training of physician/scientists. The inclusion of faculty from numerous departments across campus has produced a diverse program, and individuals selected as potential preceptors are nationally/internationally recognized scientists who have a long-term history of collaboration with investigators in the Department of Surgery. A diversity of research at UT Southwestern examines injury and inflammatory responses, enabling potential trainees to examine pathophysiologic mechanisms of trauma, sepsis, inflammation, and critical care. Trauma and sepsis constitute a major portion of health care costs in today's society. The development of clinical innovations that ultimately improve outcome of critically ill patients would be expected to reduce hospital stay and reduce the enormous financial burden that trauma and sepsis produce. Thus, the research and training described herein are particularly relevant to public health issues and concerns.